Hannes Hagström1, Patrik Nasr2, Mattias Ekstedt2, Ulf Hammar3, Linnea Widman3, Per Stål4, Rolf Hultcrantz4, Stergios Kechagias2, Martin Henriksson5. 1. Unit of Hepatology, Department of Upper GI, Karolinska University Hospital, Stockholm, Sweden; Clinical Epidemiology Unit, Department of Medicine, Solna, Karolinska Institutet, Stockholm, Sweden. Electronic address: hannes.hagstrom@ki.se. 2. Department of Gastroenterology and Hepatology, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden. 3. Unit of Biostatistics, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden. 4. Department of Gastroenterology and Hepatology, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden; Department of Medicine, Huddinge, Karolinska Institutet, Stockholm, Sweden. 5. Center for Medical Technology Assessment, Department of Medical and Health Sciences, Linköping University, Linköping, Sweden.
Abstract
BACKGROUND & AIMS: Data on healthcare resource use and costs associated with nonalcoholic fatty liver disease (NAFLD) in clinical practice are lacking. We compared real-life healthcare costs of patients with NAFLD to matched controls. METHODS: We performed a retrospective study of 646 patients with biopsy-proven NAFLD in Sweden from 1971 through 2009. Each patient was matched for age, sex, and county of residence with 10 persons from the general population (controls). We retrieved all healthcare contacts through Dec 31, 2014 from national registers. Unit costs were assigned to arrive at a total healthcare cost (in USD [$]) per study subject. RESULTS: During a mean follow-up of 19.9 years, we recorded a mean of 0.27 hospitalizations per year for patients with NAFLD vs 0.16 for controls (P < .001). This corresponded to an incremental cost of $635 per year for patients with NAFLD. Patients with NAFLD had a higher mean use of outpatient care visits: 1.46 contacts per year compared with 0.86 per year in controls, corresponding to $255 in additional costs (P < .001). Total costs incurred by patients with stage 3-4 fibrosis were higher than by patients with fibrosis stage 0-2 (mean annual costs, $4397 vs $629). Cumulative costs were higher for all stages of fibrosis compared to controls. CONCLUSIONS: Healthcare costs are nearly twice as high in patients with NAFLD than in matched controls. This is mostly attributable to higher costs for hospitalizations, but also to more outpatient visits. Patients with advanced fibrosis had the highest costs.
BACKGROUND & AIMS: Data on healthcare resource use and costs associated with nonalcoholic fatty liver disease (NAFLD) in clinical practice are lacking. We compared real-life healthcare costs of patients with NAFLD to matched controls. METHODS: We performed a retrospective study of 646 patients with biopsy-proven NAFLD in Sweden from 1971 through 2009. Each patient was matched for age, sex, and county of residence with 10 persons from the general population (controls). We retrieved all healthcare contacts through Dec 31, 2014 from national registers. Unit costs were assigned to arrive at a total healthcare cost (in USD [$]) per study subject. RESULTS: During a mean follow-up of 19.9 years, we recorded a mean of 0.27 hospitalizations per year for patients with NAFLD vs 0.16 for controls (P < .001). This corresponded to an incremental cost of $635 per year for patients with NAFLD. Patients with NAFLD had a higher mean use of outpatient care visits: 1.46 contacts per year compared with 0.86 per year in controls, corresponding to $255 in additional costs (P < .001). Total costs incurred by patients with stage 3-4 fibrosis were higher than by patients with fibrosis stage 0-2 (mean annual costs, $4397 vs $629). Cumulative costs were higher for all stages of fibrosis compared to controls. CONCLUSIONS: Healthcare costs are nearly twice as high in patients with NAFLD than in matched controls. This is mostly attributable to higher costs for hospitalizations, but also to more outpatient visits. Patients with advanced fibrosis had the highest costs.
Authors: Manuel Romero-Gómez; Jörn M Schattenberg; Jeffrey V Lazarus; Quentin M Anstee; Hannes Hagström; Kenneth Cusi; Helena Cortez-Pinto; Henry E Mark; Michael Roden; Emmanuel A Tsochatzis; Vincent Wai-Sun Wong; Zobair M Younossi; Shira Zelber-Sagi Journal: Nat Rev Gastroenterol Hepatol Date: 2021-06-25 Impact factor: 46.802
Authors: Jeffrey V Lazarus; Henry E Mark; Quentin M Anstee; Juan Pablo Arab; Rachel L Batterham; Laurent Castera; Helena Cortez-Pinto; Javier Crespo; Kenneth Cusi; M Ashworth Dirac; Sven Francque; Jacob George; Hannes Hagström; Terry T-K Huang; Mona H Ismail; Achim Kautz; Shiv Kumar Sarin; Rohit Loomba; Veronica Miller; Philip N Newsome; Michael Ninburg; Ponsiano Ocama; Vlad Ratziu; Mary Rinella; Diana Romero; Manuel Romero-Gómez; Jörn M Schattenberg; Emmanuel A Tsochatzis; Luca Valenti; Vincent Wai-Sun Wong; Yusuf Yilmaz; Zobair M Younossi; Shira Zelber-Sagi Journal: Nat Rev Gastroenterol Hepatol Date: 2021-10-27 Impact factor: 46.802